Housing Exemption Form

Housing Exemption Form
Full Name *

First Name Last Name
Student ID number *
Email (STU) *
example@stu.edu
Email (Personal) *
example@gmail.com
Phone Number *
.
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please check the Reason for your Housing Exemption. *
Please explain any additional special circumstances that will assist the Office of Residence Life & Community Standards while considering your request.
Please sign that all of the information provided are true. *

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